A case of primary torsion of the greater omentum *
A 2 5-year-old man was referred to our department with a chief complaint of right hypochondrial pain. On blood analysis, his white blood cell count and CRP had increased to 10110/mm2 and 1.8mg/dl, respectively. In the right abdomen, strong tenderness, rebound tenderness, and muscle guarding were recognized. Suspecting duodenal ulcer perforation, a laparotomy was performed. However, primary torsion of the greater omentum was found. It was twisted three times and had become necrotic. An omentectomy was performed and the postoperative course was uneventful. Although primary torsion of the greater omentum is a rare disease, it should be taken it into account as a probable diagnosis for patients with an acute abdomen. The preoperative diagnosis is difficult, even with CT or US. In this case, laparoscopic surgery could have been possible and would have been less invasive. (Accepted on My 28, 2003)
